<?php
include 'consultant.php';
include 'sub/header.tpl';
?>
<form method="post"  action="<?php echo $_SERVER['REQUEST_URI']; ?>">
    <table width="100%" cellspacing="0" cellpadding="0" id="fields" class="<?php echo Lang::getCode() == 'en' ? 'fieldsen' : '' ?>">
        <tbody>
            <tr>
                <td style="width: 295px"></td>
                <td style="padding-top: 50px" valign="top">
                    <table width="100%" cellpadding="4" cellspacing="15" >
                        <tbody>
                            <tr>
                                <td><?php echo fl('nation') ?></td>
                                <td>
                                    <select class="ctinput" name="nation">
                                        <?php
                                        $nationlist = '';
                                        $rows = Db::getRows('*', 'nation');
                                        if (Lang::getCode() == 'en') {
                                            foreach ($rows as $value => $row) {
                                                $nationlist .= '<option value="' . $row['id'] . '">' . $row['name2'] . '</option>';
                                            }
                                        } else {
                                            foreach ($rows as $value => $row) {
                                                $nationlist .= '<option value="' . $row['id'] . '">' . $row['name'] . '</option>';
                                            }
                                        }
                                        echo $nationlist;
                                        ?>
                                    </select>
                                    <span style="color:Red;display:none;" id="ct">*</span></td>
                            </tr>
                            <tr>
                                <td style="width: 135px"><?php echo fl('state') ?><span style="color:red" >(*)</span></td>
                                <td><input type="text" class="ctinput" name="state">
                                    <span style="color:Red;display:none;" >*</span></td>
                            </tr>
                            <tr>
                                <td><?php echo fl('Programs_interest') ?></td>
                                <td><select name="level" class="ctinput">
                                        <?php
                                        if (Lang::getCode() == 'vn') {
                                            echo '  <option value="1">Trung học</option>
                                                    <option value="2">Cao đẳng</option>
                                                    <option value="3">Đại học</option>
                                                    <option value="4">Sau đại học</option>';
                                        } else {
                                            echo '  <option value="1">Secondary</option>
                                                    <option value="2">College</option>
                                                    <option value="3">University</option>
                                                    <option value="4">Postgraduate</option>';
                                        }
                                        ?> 
                                    </select>
                                </td>
                            </tr>
                            <tr>
                                <td><?php echo fl('Majors') ?></td>
                                <td><input type="text" class="ctinput"  maxlength="50" name="branch">
                                    <span style="color:Red;display:none;" id="ct">*</span></td>
                            </tr>
                            <tr>
                                <td><?php echo fl('fullname') ?><span style="color:red" >(*)</span></td>
                                <td><input type="text" class="ctinput" maxlength="30" name="name">
                                    <span style="color:Red;display:none;" >*</span></td>
                            </tr>
                            <tr>
                                <td><?php echo fl('phone') ?><span style="color:red" >(*)</span></td>
                                <td><input type="text" class="ctinput" maxlength="15" name="phone"></td>
                            </tr>
                            <tr>
                                <td>Email</td>
                                <td><input type="text" class="ctinput"  maxlength="50" name="email">
                                    <span style="color:Red;display:none;" id="ct">*</span></td>
                            </tr>
                            <tr>
                                <td>&nbsp;</td>
                                <td>
                                    <br/><br/>
                                    <input type="submit" value="<?php echo fl('requestsend') ?>"></td>
                            </tr>
                        </tbody>
                    </table></td>
            </tr>
        </tbody>
    </table>
</form>
<?php
                                        include 'sub/footer.tpl';
?>
